scholarly journals Web-Based Interventions for Dietary Behavior in Adults With Type 2 Diabetes: Systematic Review of Randomized Controlled Trials

10.2196/16437 ◽  
2020 ◽  
Vol 22 (8) ◽  
pp. e16437
Author(s):  
Jedha Dening ◽  
Sheikh Mohammed Shariful Islam ◽  
Elena George ◽  
Ralph Maddison
Keyword(s):  
Glycemic Control ◽  
Clinical Outcomes ◽  
Dietary Assessment ◽  
Dietary Behavior ◽  
Dietary Guidelines ◽  
Web Based ◽  
Dietary Knowledge ◽  
Randomized Controlled ◽  
Dietary Behavior Change

Background Type 2 diabetes mellitus (T2DM) is among the most prevalent noncommunicable health conditions worldwide, affecting over 500 million people globally. Diet is a key aspect of T2DM management with dietary modification shown to elicit clinically meaningful outcomes such as improved glycemic control, and reductions in weight and cardiovascular disease risk factors. Web-based interventions provide a potentially convenient and accessible method for delivering dietary education, but its effects on dietary behavior in people with T2DM are unknown. Objective The objective of this review was to determine the effectiveness of web-based interventions on dietary behavior change and glycemic control in people with T2DM. Methods Per PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, systematic literature searches were performed using Medline, Embase, The Cochrane Library, and CINAHL to retrieve papers from January 2013 to May 2019. Randomized controlled trials of web-based interventions in adults with T2DM with reported dietary assessment were included. Population and intervention characteristics, dietary guidelines and assessments, and significant clinical outcomes were extracted. Differences between groups and within groups were assessed for dietary behavior and clinical outcomes. Results There were 714 records screened, and five studies comprising 1056 adults were included. Studies measured dietary changes by assessing overall diet quality, changes in specific dietary components, or dietary knowledge scores. Significant improvements in dietary behavior were reported in four out of the five studies, representing healthier food choices, improvements in eating habits, reductions in carbohydrates, added sugar, sodium, saturated fat and overall fat intake, and/or increases in dietary knowledge. Three studies found significant mean reductions for hemoglobin A1c ranging from –0.3% to –0.8%, and/or weight ranging from –2.3 kg to –12.7 kg, fasting blood glucose (–1 mmol/L), waist circumference (–1 cm), and triglycerides (–60.1 mg/dL). These studies provided varied dietary recommendations from standard dietary guidelines, national health program guidelines, and a very low carbohydrate ketogenic diet. Conclusions This review provided evidence that web-based interventions may be an effective way to support dietary behavior change in people with T2DM, potentially leading to changes in glycemic control and other clinical outcomes. However, the evidence should be viewed as preliminary as there were only five studies included with considerable heterogeneity in terms of the diets recommended, the dietary assessment measures used, the complexity of the interventions, and the modes and methods of delivery.

scholarly journals Web-Based Interventions for Dietary Behavior in Adults With Type 2 Diabetes: Systematic Review of Randomized Controlled Trials (Preprint)

2019 ◽  
Author(s):  
Jedha Dening ◽  
Sheikh Mohammed Shariful Islam ◽  
Elena George ◽  
Ralph Maddison
Keyword(s):  
Glycemic Control ◽  
Clinical Outcomes ◽  
Dietary Assessment ◽  
Dietary Behavior ◽  
Dietary Guidelines ◽  
Web Based ◽  
Dietary Knowledge ◽  
Randomized Controlled ◽  
Dietary Behavior Change

BACKGROUND Type 2 diabetes mellitus (T2DM) is among the most prevalent noncommunicable health conditions worldwide, affecting over 500 million people globally. Diet is a key aspect of T2DM management with dietary modification shown to elicit clinically meaningful outcomes such as improved glycemic control, and reductions in weight and cardiovascular disease risk factors. Web-based interventions provide a potentially convenient and accessible method for delivering dietary education, but its effects on dietary behavior in people with T2DM are unknown. OBJECTIVE The objective of this review was to determine the effectiveness of web-based interventions on dietary behavior change and glycemic control in people with T2DM. METHODS Per PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, systematic literature searches were performed using Medline, Embase, The Cochrane Library, and CINAHL to retrieve papers from January 2013 to May 2019. Randomized controlled trials of web-based interventions in adults with T2DM with reported dietary assessment were included. Population and intervention characteristics, dietary guidelines and assessments, and significant clinical outcomes were extracted. Differences between groups and within groups were assessed for dietary behavior and clinical outcomes. RESULTS There were 714 records screened, and five studies comprising 1056 adults were included. Studies measured dietary changes by assessing overall diet quality, changes in specific dietary components, or dietary knowledge scores. Significant improvements in dietary behavior were reported in four out of the five studies, representing healthier food choices, improvements in eating habits, reductions in carbohydrates, added sugar, sodium, saturated fat and overall fat intake, and/or increases in dietary knowledge. Three studies found significant mean reductions for hemoglobin A1c ranging from –0.3% to –0.8%, and/or weight ranging from –2.3 kg to –12.7 kg, fasting blood glucose (–1 mmol/L), waist circumference (–1 cm), and triglycerides (–60.1 mg/dL). These studies provided varied dietary recommendations from standard dietary guidelines, national health program guidelines, and a very low carbohydrate ketogenic diet. CONCLUSIONS This review provided evidence that web-based interventions may be an effective way to support dietary behavior change in people with T2DM, potentially leading to changes in glycemic control and other clinical outcomes. However, the evidence should be viewed as preliminary as there were only five studies included with considerable heterogeneity in terms of the diets recommended, the dietary assessment measures used, the complexity of the interventions, and the modes and methods of delivery. CLINICALTRIAL

scholarly journals Can autonomy support have an effect on type 2 diabetes glycemic control? Results of a cluster randomized controlled trial

2020 ◽  
Vol 8 (1) ◽  
pp. e001018
Author(s):  
Qingping Yun ◽  
Ying Ji ◽  
Shenglan Liu ◽  
Yang Shen ◽  
Xuewen Jiang ◽  
...  
Keyword(s):  
Social Support ◽  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Support Group ◽  
Autonomy Support ◽  
Controlled Trial ◽  
Support Intervention ◽  
Randomized Controlled ◽  
Cluster Randomized

ObjectivesTo assess whether social support or autonomy support intervention for patients with type 2 diabetes can achieve glycemic control at the end of intervention, and to test whether the glycemic control effect can be maintained for a long time.Research design and methodsIn this cluster randomized controlled trial, 18 community healthcare stations (CHSs) were randomized to the following: (1) usual care group (UCG) offering regular public health management services, (2) social support group (SSG) providing 3-month social support intervention based on problem solving principles, and (3) autonomy support group (ASG) offering 3-month autonomy support intervention based on self-determination theory. A total of 364 patients registered in the CHSs were enrolled into either of the three groups. The primary outcome was hemoglobin A1c (HbA1c), and secondary outcomes were diabetes self-management (DSM) behaviors. Assessment was conducted at baseline and at 3 and 6 months.ResultsPatients in ASG achieved better HbA1c reduction at the end of intervention (0.53% or 7.23 mmol/mol, p<0.001) than those in the UCG and successfully maintained it up to 6 months (0.42% or 5.41 mmol/mol, p<0.001). However, patients in SSG did not experience significant change in HbA1c at 3 or 6 months when compared with patients in UCG. Besides, patients in both the SSG (0.12, p<0.05) and ASG (0.22, p<0.001) experienced improvement in exercise at 3 months. Patients in ASG sustained improvement in exercise up to 6 months (0.21, p<0.001), but those in the SSG did not.ConclusionsAutonomy support for patients with type 2 diabetes could help achieve glycemic control at the end of intervention and successfully maintain it up to 6 months. These findings indicate that autonomy support has positive long-term effects on DSM behaviors and glycemic control and can be recommended in future diabetes intervention programs.Trial registration numberChiCTR1900024354.

scholarly journals MANAGEMENT OF ENDOCRINE DISEASE: Effects of telecare intervention on glycemic control in type 2 diabetes: a systematic review and meta-analysis of randomized controlled trials

2015 ◽  
Vol 172 (3) ◽  
pp. R93-R101 ◽  
Author(s):  
Zhenru Huang ◽  
Hong Tao ◽  
Qingdong Meng ◽  
Long Jing
Keyword(s):  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Randomized Controlled Trials ◽  
Sample Size ◽  
Plasma Glucose ◽  
Small Sample ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Randomized Controlled

ObjectiveTo review the published literature on the effects of telecare intervention in patients with type 2 diabetes and inadequate glycemic control.Design and methodsA review of randomized controlled trials on telecare intervention in patients with type 2 diabetes, and a search of electronic databases such as The Cochrane Library, PubMed, EBSCO, CINAHL, Science Direct, Journal of Telemedicine and Telecare, and China National Knowledge Infrastructure (CNKI), were conducted from December 8 to 16, 2013. Two evaluators independently selected and reviewed the eligible studies. Changes in HbA1c, fasting plasma glucose (FPG), post-prandial plasma glucose (PPG), BMI, and body weight were analyzed.ResultsAn analysis of 18 studies with 3798 subjects revealed that telecare significantly improved the management of diabetes. Mean HbA1c values were reduced by −0.54 (95% CI, −0.75 to −0.34; P<0.05), mean FPG levels by −9.00 mg/dl (95% CI, −17.36 to −0.64; P=0.03), and mean PPG levels reduced by −52.86 mg/dl (95% CI, −77.13 to −28.58; P<0.05) when compared with the group receiving standard care. Meta-regression and subgroup analyses indicated that study location, sample size, and treatment-monitoring techniques were the sources of heterogeneity.ConclusionsPatients monitored by telecare showed significant improvement in glycemic control in type 2 diabetes when compared with those monitored by routine follow-up. Significant reduction in HbA1c levels was associated with Asian populations, small sample size, and telecare, and with those patients with baseline HbA1c greater than 8.0%.

scholarly journals Effectiveness of telephone interventions as a strategy for glycemic control: an integrative literature review

2013 ◽  
Vol 22 (1) ◽  
pp. 239-246 ◽  
Author(s):  
Hérica Cristina Alves de Vasconcelos ◽  
Roberto Wagner Júnior Freire de Freitas ◽  
Niciane Bandeira Pessoa Marinho ◽  
Marta Maria Coelho Damasceno ◽  
Thelma Leite de Araújo ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Literature Review ◽  
Self Management ◽  
Inclusion Criteria ◽  
Adult Type ◽  
Randomized Controlled Clinical Trials ◽  
Randomized Controlled ◽  
Time Period

The objective of this study was to analyze the effectiveness of telephone interventions as a strategy for glycemic control in adult Type 2 Diabetes Mellitus patients. An integrative literature review was undertaken in April and May 2011 through surveys in the Cochrane, PubMed/Medline, Lilacs and Cinahl databases. Nine studies complied with the inclusion criteria, mainly randomized controlled clinical trials. Concerning the time period analyzed in each study, it varied from eight weeks to twelve months. 1294 patients participated in the study, being 671 randomized to telephone follow-ups and 479 to usual care. In eight studies analyzed, glycemic control was based on the levels of glycated hemoglobin (HbA1c). The information found showed that the interventions are effective for glycemic control in patients who have type 2 Diabetes. Self-management was improved and possible complications of the disease were reduced.

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